Earlier this month, we put out a plea for help for a very sweet little dog in desperate need of major dental surgery. We were incredibly touched by the almost immediate response from so many generous and caring people who helped make her treatment possible. Her family will be forever grateful.
Dr. Claudia gives our patient a complete exam the morning of her surgery. While we have her family’s blessing to share her photos, we were not planning to share her name. Suffice it to say, she was a little “Angel”.
Once a small blood sample is drawn, the blood is analyzed within minutes in our in-hospital laboratory by one of our team. Pre-surgical tests give us valuable information about kidney and liver function and help us choose the safest possible anesthetic plan for each pet. As soon as Beckie has Angel’s test results, she lets Dr. David and Dr. Claudia know and attaches the result to Angel’s medical file. A copy is printed to send home with Angel’s family along with a brochure explaining just what each test means.
Thankfully, Angel’s blood work tells us her organ function is excellent, so we choose the drugs to be used for her premedication and carefully calculate the quantities of each drug based on her body weight. We also print an Emergency Drug Sheet with doses pre-calculated for Angel’s weight and size because we know having doses already calculated could save valuable minutes if an emergency were to occur.
Now Dr. Claudia places a catheter into Angel’s cephalic vein. Her front leg is shaved and surgically prepped and the catheter taped in place in order that we can give intravenous fluids throughout the procedure. A catheter also ensures that we have an immediate venous access if we need to give emergency drugs.
While a little blurry, this photograph shows Dr. Claudia passing an endotracheal or breathing tube into Angel’s airway (trachea) so that she can be connected to an anesthetic machine which will deliver both anesthetic gas and oxygen and maintain a surgical plane of anesthesia.
Just like this patient in the photo on the above right, Angel was wrapped in our “Hot Dog Patient Warming Blanket”. We also wrapped her paws in bubble wrap and infant socks to keep her extra cozy. It is particularly important to keep an anesthetized patient’s core body temperature as close to normal as possible. Hypothermia can be a serious complication and is much easier to prevent than to treat.
While “Angel” is being connected to our Cardell monitor which will show her heart tracing and measure her blood pressure, oxygen saturation, temperature and respirations, Beckie takes the opportunity to perform a complimentary pedicure!
Now everyone makes sure their caps and surgical masks are in place and the charting begins in earnest. Brandy, the team member who has been designated to follow Angel’s anesthesia from start to full recovery adds notes to Angel’s anesthesia chart. This anesthesia chart will become an important part of Angel’s medical record. In addition to watching the monitors, Brandy monitors Angel’s depth of anesthesia by checking reflexes and the position of Angel’s pupils and uses her stethoscope to auscultate Angel’s heart.
Surgical masks are particularly important for the safety of our doctors and nurses because there are so many bacteria released into the air during a dental procedure. Dental instruments create a fine spray of water to cool the teeth as we work and it would be easy to breathe in bacteria if we were not wearing protective masks.
Dental disease is not only painful for pets but can contribute to the development of infections, heart disease and even kidney problems.
Angel’s “before pictures” show serious dental disease and we can already see that several extractions will be necessary.
Taking dental x-rays can give us valuable information about what is happening below the gums and expose problems we may not be able to see. Here, Dr. Dave examines a radiograph of one of Angel’s teeth.
Our patient’s dental procedures are finally complete. She is given an injection of pain medication, anesthetic is turned off and she is disconnected from surgery monitors in anticipation of her wake-up. Within just a few minutes, she is awake enough for us to remove her endotracheal tube.
Beckie gives Angel a reassuring cuddle before returning her to her kennel where warm blankets await. Dr. Claudia makes her “wake-up call” to Angel’s family and arranges her discharge for later in the afternoon. In the meantime, we will be closeby and keeping an eye on our patient. We love that our kennel area and one of our major work areas are combined. Dr. Claudia’s desk is just feet away from Angel’s kennel so they can easily see each other! Angel’s catheter is left in place for an hour or so before being removed. Then in a little while, she will be offered water and soft food and a chance to go outside for “bathroom duties”.
So now you have the story behind the smile….